I have to say that I really like Unna boots as therapy for veinous stasis ulcers. I have no idea why they are called Unna boots. If anyone knows, let me know. I couldn’t find anything on-line to explain the name. It’s an ...
Category Archives: Today In the Office
A Consultant’s Letter that Made Me Smile
Today I read a letter from a pediatric ophthalmologist after he saw a young child whose parents were concerned about his vision. One of my partners referred him for evaluation and this letter came back. I loved that the letter was not just concise and complete, but made me smile. If we all could take ...
Grand Rounds Here August 17th
This will be my first time hosting Grand Rounds. I’ve enjoyed reading posts on the Grand Rounds circuit since I started DrPullen.com last December. Thanks to Rob Lambert for helping me understand what Grand Rounds is about, and accepting a post on his version several months ago. I’ll try to make Grand Rounds Vol. ...
Pitiriasis Rosea – The Christmas Tree Rash
I was happy today to have a case of Pitiriasis rosea today in the office to show off to my medical student. The 14 year old girl with the rash was a great sport to let me show her torso rash to my young male 3rd year student. I love diagnoses that are easy, where ...
Oral Decongestants: Marginally Effective or Ineffective Drugs with Serious Potential Side Effects
I really discourage the use of pseudoephedrine and phenylephrine as a decongestants, especially in adult men. The biggest reason is that they just don’t work very well, and the potential side effects seem to outweigh the benefits. Friday in the office I saw a man in his early 50’s with acute urinary retention. ...
Grand Rounds – A Time Gone By
This week at the office I heard one of our physicians inviting our two new medical students to attend "Perinatal Grand Rounds” at a restaurant in Tacoma. My first thought was that some pharmaceutical company had the gall to call one of their sponsored programs “Grand Rounds.” Their programs are usually little more than a ...
Teaching Medical Students
I’m headed off to a reception for students from the new Pacific Northwest University of Health Sciences in Yakima, WA who are spending their third year of osteopathic medical school in Puyallup, WA doing rotations with the physicians in our community. I’ve had a student with me this week, and it brings back memories ...
Can’t Find it in there Doc?
As I went through my routine heart exam for a patient this week, he commented, “Can’t find it in there Doc?” I’m not sure if he was joking, or worried. This made me think about the routine things I do as a physician that ...
Hemicrania Continuum
I saw a patient a couple of weeks ago who had what sounded to me like trigeminal neuralgia, except that the severe one-sided head pains she was having lasted several minutes to an hour each episode, and recurred many times a day. The sharp, severe head pains of trigeminal neuralgia usually last only a ...
Exam Room Favorites
How can a physician have time to use the internet while seeing patients in the exam room. How is this possible when as a family physician I need to keep visits brief, and can’t spend time surfing the net. Actually I do go online to facilitate patient visits a few times every day. I find specific uses of ...